Cinquini



c. ClNQUlNl 2,858,898

AUSCULTATION AND PERCUSSION SOUNDING INSTRUMENT Nov. 4, 1958 Filed July29, 1953 I INVENTOR.

(A RL 0 C/lVOl/M/ AGENT United AND PERCUSSION SOUNDING INSTRUMENT CarloCinquini, Milan, Italy Application July 29, 1953, Serial No. 371,040Claims priority, application Italy August 2, 1952 3 Claims. (Cl.181--24) AUSCULTATION ment to assume a disadvantageous overall size,which often actually hinders the sounding of certain parts of the bodyof patients whose conditions prescribe absolute immobility. Otherimproved phonendoscope types provide a forked peripheral tubularextension instead of said perpendicular pieces, but inasmuch as it isnecessary to take hold of the phonendoscope by hand, the same abovementioned inconveniences arise from the size of this h man organ.Furthermore, there are already known improved phonendoscopes whereinmeans are provided for regulating the sound reception and amplifyingcharacteristics of the instrument, but these provisions do not assuresatisfactory results and these means are placed so that the same abovementioned disadvantages arise therefrom. Another important drawbackarises from the disturbing influence of the hand which has to grip thephonendoscope on the sound chamber and on the flexible binaural tubes,which influence may alter the sounding results.

On the other hand the percussion sounding hammer is generally providedas an independent element of the physicians kit, and since itcontributes generally to encumber even more the limited room of, forinstance, a portable medical case, it is often left out and undesirableconsequences may arise therefrom.

It is accordingly a first object of'the invention to provide aninstrument suitable to perform both the functions of sounding patientsby auscultation as well as by percussion.

A further object of the invention is to provide means designed toinsulate the sound chamber of the instrument as well with respect to thephysicians hand as with respect to other external influences, therebyimproving the detection and sensing of the sounds.

Another object of the invention is the provision of an instrumentallowing the physician (without any other means besides those necessaryin order to attain the first of said objects) to examine by auscultationsuch organs of a patient whose condition renders him unable to move andtherefore causes these organs to be generally inaccessible to otherconventional instruments of this class.

A still further object of the invention is to provide means forregulating the acoustic characteristics of the sound chamber of theinstrument, such means being able to serve also to sense the cutaneoussensitivity and to detect the relative reflexes.

These and other objects are attained by the instrument rates Patentaccording to the invention, wherein the acoustic chamber, formed as acavity in the instrument body and having a vibrating diaphragm closure,is provided with a peripheral tubular rigid extension constituting ahandle for the instrument, the free end thereof being suitably forked soas to allow the flexible binaural tubes to be connected thereto; themarginal wall of said chamber being provided with a coating of yieldingmaterial; means being provided in combination with said chamberforregulating the acoustic characteristics thereof.

For a fuller understanding of the nature and objects of the inventionreference should be had to the following detailed description taken inconjunction with the accompanying drawing in which- Fig. 1 is alongitudinal sectional view of a preferred embodiment of an instrumentaccording to the invention, and

Fig. 2 is a cross section along the line IIII of Fig. 1.

Referring now more particularly to the drawing, the instrument is formedby a generally circular body 1, having a large circular recess 2 whichforms the acoustic chamber. The front part of the edge of body 1 isthreaded at 3 so that a ring 4 may be screwed thereon in order to secureto said edge a vibrating diaphragm 5. The rear part of said edge of thebody 1 is provided with an annular groove 6 designed to receive a ring 7of yielding material, such as rubber or the like, which serves toinsulate the chamber 2 from external disturbances and to damp thesounding percussions. The chamber 2 is connected through the hole 8 withtwo passages 9, 10. A nipple 17, traversed by the passage 10, extendsoutwardly from body 1 and passes through ring 7. A tubular handle 11 isconnected to the passage 9 and forms the rigid extension according tothe invention; a pointed-apex screw 12 having, its threaded sternpartially faceted at 12' and terminating in a knurled head 13 is screwedinto nipple 17 and thus extends within the second passage 10. The handle11 is slightly curved in order to permit the hand which grips it to besufliciently spaced from the organ to be sounded so as to afford easygripping as well as suflicient pressure of the diaphragm upon the humanorgan referred to. Said handle is provided at its end with a tubularextension 14, with forked free ends 15, 16 to which the binaural tubes(not shown) are to be connected.

Thus the physician or the examiner can grip the handle 11 and displacethe body 1 till it reaches the organ to be sounded by auscultation. Thevibrations of the sensitive diaphragm 5 are transmitted to the air whichis stored in the chamber 2 and from here through hole 8 and passage 9 tothe extensions 11 and 141516 reaching the binaural tubes. Inasmuch asthe handle 11 is of sufficient length, no contact can occur between thehand of the examiner and the flexible binaural tubes, and therefore nodisturbance affects the latter.

It is obvious that the body can be gripped also by means of the rubberring 7 assuring to the same extent as in the above considered instance acomplete insulation of the instrument from the possible disturbancesarising from the physicians hand.

In order to adjust the acoustic characteristics of chainber 2, the screw12 has to be tightened or loosened, for instance by the thumb of thehand which grips the handle 11, thus permitting the user to adjust or tointerrupt the communication of the interior of the chamber 2 with theatmosphere, along the clearance between the passage 10 and the facetedscrew face 12.

The ring 7 of rubber or the like enables the instrument during its useas a percussion hammer to have its percussions damped, since said ringforms the contact surface. Obviously the component elements andmaterials of the Patented Nov. 4, 1958' instrument are selected so as toafford the necessary weight for the hammer.

The pointed-apex screw 12, besides providing an adjusting means, mayserve to sense the cutaneous sensitivity and the neuromotor reflexes.

Since certain changes may be made in the construction set forth and incarrying out the above device, and different embodiments of theinvention may be provided without departing from the scope of theinvention, it is intended that all matter contained in the abovedescription or shown in the accompanying drawing shall be interpreted asillustrative and not in a limiting sense.

I claim:

1. A medical sounding instrument comprising a flat, disk-like bodyprovided with an internal cavity and having one of its faces formed witha recess communicating with said cavity, a vibratory diaphragm overlyingsaid recess, said body having a pair of divergent passages extendingfrom said cavity to the periphery of said body, an elon gated tubularhandle extending radially from said body and having a bore communicatingwith one of said passages, and an elongated control member extendingbeyond the periphery of said body Within the other of said passages andsurrounded beyond said periphery by an integral radial extension of saidbody, said control member having an extremity projecting beyond saidextension for varying the degree of acoustic coupling between saidcavity and the surrounding atmosphere by changing the position of saidmember within said other passage, said body being provided along itsperiphery with resilient cushioning means traversed by said extension.

2. An instrument according to claim 1, wherein said control member is aneedle threadedly engaging a portion of said body and provided with apointed extremity extending toward said cavity of said body, said needlehaving a faceted side forming a channel within said other passage, saidprojecting extremity comprising an enlarged head closing said passage ina limiting position of said needle.

3. A medical sounding instrument comprising a flat, disk-like bodyprovided with an internal cavity and having one of its faces formed witha recess communicating with said cavity, a vibratory diaphragm overlyingsaid recess, said body being provided with an integral radial extensionhaving a central bore communicating with said cavity, said body furtherhaving a radial passage, said bore and said passage extending at anacute angle to each other Within a plane parallel to said diaphragm, anelongated tubular handle extending radially from said body and havingits interior communicating with said passage, and a needle-shapedcontrol member threadedly received in said extension and provided with ahead positioned beyond said extension, said member having a faceted sideforming a channel within said bore which communicates with thesurrounding atmosphere except in a position in which said head abutssaid extension whereby the degree of coupling between said cavity andthe surrounding atmosphere may be varied by changing the position ofsaid member within said bore.

References Cited in the file of this patent UNITED STATES PATENTS872,448 Penhall'ow Dec. 3, 1907 899,815 Townsend Sept. 29, 19081,485,124 Myres Feb. 26, 1924 1,658,327 Dodge Feb. 7, 1928 1,708,398Pilling Apr. 9, 1929 1,763,687 Chadwick et al. June 17, 1930 2,158,764Silka May 16, 1939 2,196,342 Ruttenberg Apr. 9, 1940 2,299,749 HowardOct. 27, 1942 2,301,638 Olson Nov. 10, 1942 2,342,334 FaltiCO Feb. 22,1944 2,358,099 Polk Sept. 12, 1944 2,515,471 Ratzan July 18, 19502,541,164 Huenlich Feb. 13, 1

FOREIGN PATENTS 214,154 Great Britain Apr. 17, 1924

